Application  for Membership
& Dues Renewal Form

NATIONAL ASSOCIATION OF WATCH AND CLOCK COLLECTORS, INC.

U.S. Members $65.00

International (non U.S.) $65.00 USD per year (please review the optional airmail rates). Payments for non-U.S. members may be made with U.S. funds drawn on a U.S. bank, by International Money Order, or by VISA, MasterCard, DISCOVER or Am. Express.

An additional Family Membership (for a spouse/significant other or children under the age of 18 that are living at the same address) receiving no publications costs $20.00 per year.

The following air mail rates are available to our International members. All of the rates are to be paid on an annual basis. There is no refund on these rates in case of death or resignation.

• International First-Class Mail Handling: (this includes the Mart and the Bulletin bundled together)
  • Rate Group 1—Canada = $28
    
  • Rate Group 2—Mexico = $39
    
  • Rate Group 3—All other International (not including Canada and Mexico) = $63
    • Airmail is not available to continental US states
    • Airmail rates are paid on an annual basis. There is no refund on these rates in case of death or resignation

PLEASE PRINT OR TYPE

MR., MRS., MS., OTHER_______________________________________________

ADDITIONAL FAMILY MEMBER _______________________________________
            _____ Spouse/Significant Other      ______ Son/Daughter under 18

STREET__________________________________________________________

CITY_____________________________________________________________

STATE/COUNTRY______________________ZIP+4_______________________

OCCUPATION_____________________________________________________

PHONE NUMBERS:

WORK ( ___)____________________HOME (___)________________________

FAX (___)_______________________

EMAIL ADDRESS: _________________________________

BIRTHDAY ___________________________

Have you ever been a member? Yes (___) No (___)

If yes, what was your number? _________________

What are your horological interests? (Please specify, such as clocks, watches, etc.)

______________________________________________________________

______________________________________________________________

______________________________________________________________

SPONSOR:_____________________________ Membership # ____________

ADDRESS _____________________________________________________

______________________________________________________________

Is this a gift membership? _____ If "YES", From: _____________________
(if YES, a gift card will be included with membership card)

Gift giver's phone number: _________________________

Amount of Payment ____________ Date of Payment ____/____/____

Circle One:
Check enclosed     VISA    MasterCard     Discover     American Express

Card Number ___________________  Exp. Date _________________

Credit card security code from back of card (CSS): _____

Cardholder's name _________________________________

(For Office use -- Do Not Write Below This Line)

Enclose with remittance and send to:

NAWCC® 514 Poplar Street, Columbia, PA 17512-2130
(717) 684-8261 - fax: (717) 684-0878

Last Updated:  Monday, October 16, 2006 01:38 PM
Copyright © 2005 National Association of Watch and Clock Collectors